Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry

被引：723

作者：

Chioncel, Ovidiu ^{[1
,2
]}

Lainscak, Mitja ^{[3
]}

Seferovic, Petar M. ^{[4
,5
]}

Anker, Stefan D. ^{[6
,14
]}

Crespo-Leiro, Maria G. ^{[7
]}

Harjola, Veli-Pekka ^{[8
]}

Parissis, John ^{[9
]}

Laroche, Cecile ^{[10
]}

Piepoli, Massimo Francesco ^{[11
]}

Fonseca, Candida ^{[12
]}

Mebazaa, Alexandre ^{[13
]}

Lund, Lars ^{[15
,16
]}

Ambrosio, Giuseppe A. ^{[17
]}

Coats, Andrew J. ^{[18
,19
]}

Ferrari, Roberto ^{[20
,21
,22
]}

Ruschitzka, Frank ^{[23
]}

Maggioni, Aldo P. ^{[24
]}

Filippatos, Gerasimos ^{[25
]}

机构：

[1] Univ Med & Pharm Carol Davila, Bucharest, Romania

[2] Inst Urgente Boli Cardiovasc CC Iliescu, Bucharest, Romania

[3] Gen Hosp Celje, Dept Cardiol, Celje, Slovenia

[4] Univ Belgrade, Med Ctr, Dept Internal Med, Belgrade, Serbia

[5] Univ Belgrade, Med Ctr, Heart Failure Ctr, Belgrade, Serbia

[6] Univ Med Ctr Gottingen UMG, Innovat Clin Trials, Dept Cardiol & Pneumol, Gottingen, Germany

[7] CHUAC, Unidad Insuficiencia Cardiaca Avanzada &Trasplant, La Coruna, Spain

[8] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Dept Emergency Med & Serv, Helsinki, Finland

[9] Attikon Univ Hosp, Athens, Greece

[10] European Soc Cardiol, EURObservat Res Programme, Sophia Antipolis, France

[11] AUSL Piacenza, Heart Failure Unit, Cardiac Dept, Guglielmo de Saliceto Hosp, Piacenza, Italy

[12] Univ Nova Lisboa, Heart Failure Unit, S Francisco Xavier Hosp, Ctr Hosp Lisboa Ocidental,NOVA Med Sch,Fac Cienci, Lisbon, Portugal

[13] Univ Paris Diderot, Sorbonne Paris Cite, Paris, France

[14] Hop Univ St Louis Lariboisiere, AP HP, Dept Anaesthesia & Crit Care, Paris, France

[15] Karolinska Inst, Dept Med, Stockholm, Sweden

[16] Karolinska Univ Hosp, Stockholm, Sweden

[17] Univ Perugia, Sch Med, Perugia, Italy

[18] Monash Univ, Clayton, Vic, Australia

[19] Univ Warwick, Coventry, W Midlands, England

[20] Univ Hosp Ferrara, Dept Cardiol, Cotignola, Italy

[21] Univ Hosp Ferrara, LTTA Ctr, Cotignola, Italy

[22] ES Hlth Sci Fdn, Maria Cecilia Hosp, GVM Care & Res, Cotignola, Italy

[23] Univ Heart Ctr Zurich, Dept Cardiol Heart Failure Clin & Transplantat, Zurich, Switzerland

[24] ANMCO Res Ctr, Florence, Italy

[25] Univ Athens, Univ Hosp Attikon, Sch Med, Athens, Greece

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2017年 / 19卷 / 12期

关键词：

Ambulatory; Chronic; Heart failure; Left ventricular ejection fraction; Outcomes; CORONARY-ARTERY-DISEASE; EUROPEAN-SOCIETY; CO-MORBIDITIES; ASSOCIATION; SPECTRUM; PILOT;

D O I：

10.1002/ejhf.813

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims The objectives of the present study were to describe epidemiology and outcomes in ambulatory heart failure (HF) patients stratified by left ventricular ejection fraction (LVEF) and to identify predictors for mortality at 1 year in each group. Methods and results The European Society of Cardiology Heart Failure Long-Term Registry is a prospective, observational study collecting epidemiological information and 1-year follow-up data in 9134 HF patients. Patients were classified according to baseline LVEF into HF with reduced EF [EF < 40% (HFrEF)], mid-range EF [EF 40-50% (HFmrEF)] and preserved EF [EF > 50% (HFpEF)]. In comparison with HFpEF subjects, patients with HFrEF were younger (64 years vs. 69 years), more commonly male (78% vs. 52%), more likely to have an ischaemic aetiology (49% vs. 24%) and left bundle branch block (24% vs. 9%), but less likely to have hypertension (56% vs. 67%) or atrial fibrillation (18% vs. 32%). The HFmrEF group resembled the HFrEF group in some features, including age, gender and ischaemic aetiology, but had less left ventricular and atrial dilation. Mortality at 1 year differed significantly between HFrEF and HFpEF (8.8% vs. 6.3%); HFmrEF patients experienced intermediate rates (7.6%). Age, New York Heart Association (NYHA) class III/IV status and chronic kidney disease predicted mortality in all LVEF groups. Low systolic blood pressure and high heart rate were predictors for mortality in HFrEF and HFmrEF. A lower body mass index was independently associated with mortality in HFrEF and HFpEF patients. Atrial fibrillation predicted mortality in HFpEF patients. Conclusions Heart failure patients stratified according to different categories of LVEF represent diverse phenotypes of demography, clinical presentation, aetiology and outcomes at 1 year. Differences in predictors for mortality might improve risk stratification and management goals.

引用

页码：1574 / 1585

页数：12

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